Andrea Richman: Filling the gap in oral health care

Thursday

Jan 31, 2008 at 12:01 AMJan 31, 2008 at 3:47 PM

When it comes to the issue of access to care for basic oral health services, there is at least one point where there should be no disagreement. The fact that millions of Americans continue to suffer from dental disease because they cannot afford to pay for these services is indeed a disgrace. Living in the most affluent country in the world, we should all be ashamed that this situation still exists in the 21st century.

Andrea Richman

When it comes to the issue of access to care for basic oral health services, there is at least one point where there should be no disagreement. The fact that millions of Americans continue to suffer from dental disease because they cannot afford to pay for these services is indeed a disgrace. Living in the most affluent country in the world, we should all be ashamed that this situation still exists in the 21st century.

A recent study by the Catalyst Institute clearly indicates the need for a comprehensive approach to improving oral health care in Massachusetts. Unlike other states, Massachusetts has a fragmented system with no overall oral health plan. To address this situation, the first step should be to approve a position for a dentist to serve as head of the state's Office of Oral Health.

There are many barriers to accessing dental care, which are a combination of financial, cultural, and geographic. The Massachusetts Dental Society (MDS) has been working to increase the number of dentists who participate in the MassHealth program. This past May, the MDS took the unprecedented action of approving a resolution at its House of Delegates asking all of our nearly 5,000 members to enroll in this program.

Although dentists are the caregivers under MassHealth, state government needs to play an important role by making it easier for dentists to participate, and the legislature and governor should consider increasing funding for this program, since the rates paid are still significantly less than the actual cost of providing care.

The public sector needs to be energized in improving access to care, as well. We presently have more than 70 positions for dentists in community health centers, which are not filled due to lack of adequate funding. A program of tuition forgiveness for public service may also help to alleviate this problem, as well as address the issue of a lack of diversity among dental school graduates.

The sad truth, however, is that dental decay is a largely preventable disease with proper attention to diet, the application of sealants, and water fluoridation. Fluoridation is the single most important tool we have against the ravages of decay. Unfortunately, many communities still have not taken the necessary steps to provide fluoridated water to its residents.

Despite these obstacles, dentists in Massachusetts are already doing their part.

Since February 2007, a dental van, sponsored by the Massachusetts Dental Society (MDS) Foundation, has been traveling all across Massachusetts providing free oral health care to children who otherwise would not have access to even the most basic dental treatment. To date, volunteer dentists have treated 1,400 children statewide, and more than $300,000 in free care has been donated.

To some, this may seem like a drop in the bucket compared to the overflow in demand for dental treatment. The van, however, is at least one way to take the access issue in the right direction.

The MDS has also filed legislation on Beacon Hill to create expanded duties and career ladders for dental hygienists and dental assistants. By giving hygienists and assistants the proper training to take on more responsibilities in the dental office, it allows dentists to see more patients in the course of an average workday. It is critical that this important legislation be passed, as well as a bill to allow retired dentists to more easily volunteer their time and expertise.

No, all these initiatives alone won't solve the access to care problem. That's why we invite governmental officials, community leaders, and other interested organizations to join the dental community in finding viable solutions. Oral health is part of overall health, so oral health care must be a priority.

Dentists are dedicated to using their training and expertise to make people look and feel good. It is our moral responsibility, however, to also do good... something, as a profession, we take just as seriously.

But providing the solutions to this growing problem should not fall solely to the dental community. Unlike a hole in a tooth that can easily be filled, when it comes to filling the massive hole in our oral health care system so that those in need don't fall through the cracks, unfortunately, there is no quick fix.

With the support of others, dentists in the Massachusetts can lead the way to enhancing the oral health of Bay State residents, while at the same time helping to give all mouths a real voice.

Andrea Richman, DMD, is president of the Massachusetts Dental Society.